OBJECTIVES: High levels of n-3 fatty acids and other nutrients in traditional Inuit food appear to provide some protection against the typical diseases of affluent industrialized societies: cardiovascular diseases and type 2 diabetes. An increased intake of imported food among Inuits will probably increase their frequency of these diseases. However, since the 1970s it has become evident that the marine-based Inuit diet also contains high levels of potentially toxic lipophilic organic pollutants and heavy metals. Since these two food related opposing health effects appear to be inseparable, the phenomenon has been known as "The Arctic Dilemma". However, both the fatty acid composition and the contaminant levels vary in Greenlandic food items. Thus in principle it is possible to compose a diet where the benefits and risks are better balanced. Our objectives of this study were to compare traditional and modern meals in Greenland concerning the dietary composition, nutrients, and health indicators among the consumers. STUDY DESIGN: The present study was a cross-sectional dietary survey as part of the Arctic Monitoring and Assessment, Human Health Programme (AMAP). These results were compared with older dietary surveys in Greenland. METHODS: Dietary components, fatty acids, and nutrients in 90 local meals collected by duplicate portion method in Uummannaq town, north Greenland 2004 and in Narsaq, south Greenland 2006, were compared with 177 duplicate meals sampled in the village of Igdslorsuit, Uummannaq, district, 1976 and also compared with other dietary studies in Greenland 1953-1987. Anthropometric measures (weight, height, and body mass index, BMI) and blood lipids were measured as health indicators among the participants. RESULTS: Between the traditional foods sampled or analysed 30-50 years ago and the modern food from 2004 to 2006, significant differences were found in the dietary composition. The percentage of local food had decreased, to a present average of about 20% and with it the dietary content of n-3 fatty acids. Also, the intakes of many vitamins and minerals had decreased, and were below Nordic Nutrient Recommendations in 2004 and 2006. Vitamin A, B(1), (B(2)), B(12), iron, iodine, phosphorus, and selenium contents were correlated with n-3 content, whereas vitamin C, folate, and calcium contents were not and the same time very low. In the traditional food, especially from the villages, the intakes of vitamin A, vitamin D, and iron were extremely high and borderline toxic. The levels of contaminants such as organochlorins and heavy metals were also strongly correlated with the relative content of local food in the diet. The best balance between potentially beneficial and harmful substances was found for 20-30% local food, corresponding to a daily intake of 3-5 g of n-3 fatty acids. Body weight, height, body mass index (BMI), cholesterol, and S-triglycerides had increased significantly between 1976 and 2004. CONCLUSION: The dietary changes to a more western fare were found to be negative resulting in less adequate nutrient coverage but at the same time lower contaminant load. Thus, we recommend not to increase the consumption of local products beyond the present level but rather to improve the quality of the imported food. Udgivelsesdato: 2007-Oct-1